A Study of Lower Lung Tuberculosis

Abstract

When tuberculosis is confined to the lower lung fields, it often masquerades as pneumonia and the correct diagnosis gets delayed. Early diagnosis and treatment helps in the prevention of complications, a proper understanding of clinical, radiological, and bacteriological presentations, as well as treatment outcome of this disease entity is of crucial importance. This study was taken up to study the clinical features of lower lung field tuberculosis in a rural tertiary care centre in South India. From August 2011 to July 2012, 40 cases of Lower lung field Tuberculosis admitted to medical wards were studied. 24(60%) were males, 28(70%) were >40 age, 38(95%) had respiratory symptoms in the form of cough and scanty expectoration, 30(75%) had mild to moderate fever, 21(52.5%) had weight loss, 4(10%) had pleuritic pain, 6(15%) had scanty hemoptysis. Both lungs were equally involved with slight preponderance to right lung, 6(15%) had bilateral involvement. Predisposing conditions - 14(35%) diabetic, 4(10%) past history of PTB and 2(5%) had HIV. 2(5%) were sputum negative had unresolving pneumonia which responded to ATT. Conclusion: Tuberculosis should be considered when lower lung fields are involved, in elderly, Diabetics, HIV, immunocompromised and when the radiologic picture suggests unresolved pneumonia. Further investigation needed to confirm the Diagnosis of Lower Lung Tuberculosis. Response is similar as apical tuberculosis.